After getting some Covid symptoms and testing positive on a rapid test last Monday, this morning I completed the 5-day Paxlovid treatment regimen.
My symptoms (nasal congestion and a cough) have been gone for a few days. The rapid test I took this afternoon was negative. So things are looking good.
And I'm not all that worried about Paxlovid rebound, which doesn't seem like a big deal to me.
Nobody really knows how many people who take Paxlovid either get Covid symptoms after the 5-day treatment is over, or test positive after testing first positive, then negative, then positive again. A Scientific American story says:
The Pfizer clinical trial reported between 1 and 2 percent of those who received the drug tested positive for COVID after finishing the Paxlovid course; their illness rebounded. Those rebounds were not statistically different from rebounds experienced by people with COVID who received the placebo, however.
And a Los Angeles Times story strikes a cautionary tone.
This is a story about a COVID-19 medication, a nasty trick the coronavirus sometimes plays on its victims, and how the two became a pandemic couple called “Paxlovid rebound.”
It’s also a story about how looks can be deceiving.
Americans have been quick to embrace the idea that the antiviral drug is to blame for COVID-19 relapses in people just days after they’ve seemingly recovered. President Biden was said to have experienced Paxlovid rebound this summer, after White House doctors declared him coronavirus-free. The same thing happened to Dr. Anthony Fauci and Stephen Colbert, among others.
It’s tempting to presume a cause-and-effect relationship between two things that occur in quick succession. And even when events are completely random, we tend to see the patterns we expect to find.
But researchers are not so sure Paxlovid rebound is real. Relapses have occurred in COVID-19 patients who didn’t take the drug — they just didn’t get as much attention when there wasn’t a new medicine to blame.
Doctors fear some patients who could benefit from Paxlovid are skipping it in an effort to avoid a boomerang bout of COVID-19. That’s troubling because the medication has been found to powerfully reduce the risk of hospitalization or death in the unvaccinated, older people and those with compromised immunity. Preliminary research hints it may even reduce the risk of long COVID.
Today I shared some thoughts with a friend about the subject of Paxlovid rebound. She also took Paxlovid, but is still testing positive about a week after the treatment ended. She shared an email from her doctor, which I cited in my own message.
The way I see it, your doctor and my pharmacist are saying the same thing. Paxlovid doesn’t cause any virus lingering in the body after the 5-day treatment regimen to somehow pop back up and reinfect the person. It’s the Covid virus that caused the initial infection and it’s the Covid virus that causes any negative test result at the end of treatment to turn into a positive test result later on.
As your doctor correctly noted, Paxlovid puts a brake on replication of the virus during the 5-day treatment period. If a person’s body/immune system wasn’t able to clear all of the virus during that period, or if the person for one reason or another didn’t respond properly to the Paxlovid treatment, then any residual virus can emerge after the Paxlovid brake is turned off after the 5-days.
So if a positive test result occurs after Paxlovid, as has happened with you, this doesn’t mean Paxlovid is responsible. Paxlovid did what it should. And the Covid virus is doing what it does so well, replicate if given the chance.
I look at the situation this way. Without Paxlovid, you or I might well have spent several weeks suffering from moderate symptoms. That was the case with a woman I know, somewhat younger than me, who got Covid and emailed me, “I hope you get over it more quickly than I did.” I recall she was sick for a couple of weeks.
So we take Paxlovid. It puts a brake on the virus replicating in our bodies. We have mild symptoms. If after the brake is released, some residual virus causes a positive test result some days after the end of Paxlovid treatment, we’re still considerably better off than if we hadn’t taken Paxlovid at all, because of the 5-day brake period, which enabled our bodies to better fight the comparatively small amount of virus that the Paxlovid brake couldn’t stop.
Like you said, it seems to come down to word choices. The word “rebound” conjures up an image of something happening that shouldn’t, whereas actually a positive test result after the 5-day course of treatment isn’t surprising, if some residual virus remained in the body after the five days. Some people seem to view “rebound” as meaning that Paxlovid caused two Covid infections rather than just one, which makes them reluctant to take Paxlovid. Of course, there was just one Covid infection.
They don’t realize that if they qualify to get Paxlovid, they should take it, since whatever happens with the course of treatment, they’ll be better off than if they just let Covid run its course in their body without Paxlovid. I took another rapid test about an hour ago: negative. So that’s good news. Of course, I’ll re-test myself every few days to see if a positive test result emerges.
I couldn’t tell from your message whether you took a rapid test after the 5-day course of treatment. If so, I’m curious if it was negative.